To all whom it may concern Be it known that I, EDWIN P. BUeBnn, a citizen of the United States, and a resident of Vernon, in the county of Oneida and State of New York, have invented certain new and useful Improvements in Suturing Instruments; and I do hereby declare that the following is a full, clear, and exact description thereof, which will enable others skilled in the art to which it appertains to make and use the same, reference being had to the accompanying drawings, and to the reference numerals marked thereon, which form part of this specification.

The purpose of my invention is to provide an improved suturing instrument which is simple in construction and operation, eflicient in action and adapted for use in a large variety of circumstances.

A further purpose is to provide a sutur ing instrument which is especially adapted for use in restricted cavities or confined locations and which can be placed in such positions and readily, eifectively and safely manipulated in such locations.

A still further purpose is to provide an instrument of the class described wherein the needle is entirely enclosed in a casing or cavity before the instrument is inserted into or brought near the body and in which the needle is passed from such holding cavity in o a receiving cavity between the jaws of the receiving forceps without any possibility of its being accidentally brought into con-v tact at either end with any other tissue than the portion of tissue grasped between the flesh-engaging faces of the flesh-grasping forceps of the instrument.

A further purpose is to provide an instrument of the class described wherein the threaded needle is securely housed in a cavity or casing forming a part of the needle-delivering forceps before the instrument is applied to the body and wherein the needlereceiving forceps are firmly but detachably fastened to the needle-delivering forceps before the instrument is brought into actual operation so that the needle will Stay in initial position until positively operated and then will be positively grasped by the needle-receiving forceps; furthermore an Serial No. 520,038.

object is to produce an instrument wherein the travel of the needle is definitely directed as to its course and amount and then positively grasped by part of the apparatus.

Another object is to provide a pair of flesh-grasping forceps having thereon means for initially holding the needle and moving it forward through the tissue with certainty as to direction and extent of motion and also to provide the same parts in combination furthermore with means for grasping the needle with certainty and positiveness after the needle has been passed through or substantially through the tissue being operated upon.

A further object is to provide an apparatus of the character described of such construction, form and operation that it may be used effectively and safely in any position or at any angle and with a minimum of or even absence of. sight of the parts being operated upon.

A still further advantage is to provide an instrument of the class described which is adapted to operate in a very small cavity on account of the parts being very compact and closely assembled at the operating end and on account of the curved formation of the jaws as they extend back from the points of the jaws to the pivot of the forceps.

Fig. 1 is a top or plan view of the complete suturing instrument assuming the instrument to be in the relative position there indicated. so as to pass the needle from the right hand to the left hand side of the instrument during the sewing operation. It will be understood that for clearness and convenience of description and illustration in the drawings and specification the instru ment is in this position (except where e ressly otherwise stated). It is obvious, however, that the instrument may in practice be turned on its general longitudinal axis or otherwise so as to perform the suturing operation in any direction desired.

In Fig. l the jaws of the flesh-grasping and needle-delivering forceps A are in closed position and the needle-operating mechanism is in withdrawn position ready for operation. In this view also the jaws of the needle-receiving forceps B are shown attached to the back of the co-operating jaw of the other forceps 2 is a top or plan view of the fleshgrasping and needle-delivering forceps A in the same position shown in Fig. 1 and Fig. 3 is a left hand side view of the said forceps.

Fig. 4 is a plan view of the needle and thread used in the instrument.

Fig. 5 is a horizontal cross sectional view on an enlar ed scale of the jaws of both pairs of forceps with the needle in position but with only the projecting ends of the thread shown.

F ig. 6 is a view similar to Fig. 5 but with the needle-delivering mechanism moved forward so that the needle has been pushed over into the needle-receiving forceps l3 ready to be seized by the jaws of-the needle-receiving forceps B.

Fig. Tis a vertical cross sectional view on an enlarged scale of the jaws both pairs of forceps along the axis 7-7 as seen in the direction indicated by the arrows.

Fig. 8 is a similar view showing only the jaws of the needle-receiving forceps B.

Fig. 9 1s a similar view showing only the left hand jaw of the needle-delivering forceps A. I

Fig. 10 is a top or plan view of the needle receiving forceps l3.

Fig. 11 is a right hand edge view of the same with jaws open ready to receive the needle. v

Fig. 12 is an end view of the handle j arts only of the same forceps.

Fig. 13 is a right hand edge view on an enlarged scale of the jaws of the needlereceiving forceps in the open position ready to receive the needle.

Fig. 14 is a view similar to Fig. 13 but with the jaws closed tightly on the needle.

Fig. 15 is a vertical cross sectional view on an enlarged scale along the axis 15-15 showing the jaws of the needle-receiving forceps in the open position.

Fig. 16 is a similar view showing the jaws closed tightly on the'needle.

Referring to the drawings in a more particular description it will be seen that the suturing instrument consists of two main' parts, one the flesh-grasping and needle delivering forceps A and the other the needle-receiving forceps The forceps A consist of two main members 20 and 21 crossing each other and pivoted to each other by pivot screw 22 resulting in the member 20 having a jaw 23 and a long handle 2% and the member .21 having a jaw 25 and long handle 26. Preferably near their extremities the handles 24 and 26 will be provided with thumb and finger rings 27 and respectively common to surgical instruments. .The opposing;- faces 2r of "he 23 and 25 of the jaw 25 form the flesh or tissue grasping faces of the entire instrument. In all of the draw s these aces'are shown without tissue-in vening therebetween but it will be obvious that they may be or left hand face of the jaw as the parts are seen in Figs. 1, 2 5 and 6. This aperture allows the needle and its thread or suture 33 to be passed through said j'aw.

At the right hand face 23 the aperture is only slightly larger than the needle which passes through it. At a point back from face 23 say about one-third the thicln ness of jaw 23 the aperture is much larger and then tapers to a smaller diameter at the left hand face of the jaw asshown in Fig. 9. This tapering shape is for the purpose of providing means to detachably secure to this jaw the jaws of the needlereceiving forceps B as will be hereinafter described. The extending of the face 23 to provide only a hole large enough for the passage of the needle therethrough provides a guard to prevent the ends 47 and 49 of the needle-receiving jaws engaging or 'iinchin'g the flesh as the jaws of the needle-receii ing jaws are forced together.

The jaw 25 is enla ed so as to extend a considerable distanceback from its fleshengaging face 25 in the form of a casing 3 having provided thereina curved or arc shaped cavity 35 the casing being generally in the form of a curved cylinder with one end of its cavity 35 extending to the flesh-grasping fare 25 and the other end open to receive the needle-operating plunger 36.

This plunger 36 at all times has its for- Ward end 36 within the cavity 35 and the whole length of the plunger is curved to fit the curve of the needle cavity 35. 'The plunger is pivotally mounted so as to have its forward end pushed forward'through the greater extent ofthe needle cavity 35 by means of the rear end 36 of the plunger being secured to a block 37 generally triangular in shape as more particularly shown in Figs. 5 and 6. This block is pivotally mounted near one corner to the jaw 25' by pin 38 placed at the center of the curve of the cavity 35. To the right hand corner of the block 37 as seen in 2, 5 and 6 by means of pin 39 there are pivoted tee forward extremities of a forked operating push rod 40 the freeend of which rodextends out past the finger rings 27 and 28 far enough for convenient manipulation. Preferably the swinging block 37 is mounted in a recess formed in the middle portion of the jaw 25 with the rear end of the plun ger'36 secured to the lib 1-35 through the aperture in the flesh-engaging the thread or suture 33 xtend from the eye in the rear end of is will extend out through so that when the needle is pushed from the cavity through the in jaw 25 and through the l recess 4L2 forwu rd aperture tissue between the Flesh-ens; 'ing jaws of these forceps and with T ant passed through the aperture Si in the jaw 23 the free end the thread ill be upon'the right hand side of the ties being operated upon. It will be understood that the needle is bent or curved to contorm generally to the curve of the cavity and that t 11s curved formation oi": the needle and its cav ity and the casing 34 is to enable the in strurnent to have as compact a head as possible in order that i may be used in sinall cavities.

The needle-receiving) "forceps consist of e pair of main members 4H.- and d5 crossing; each other and pivoted to each other by pivot screw resulting); in the member having a relatively short l and relatively long handle and resulting similarly in member h ving a short jaw 4T9 and a relatively long; handle 50. Preterebly the extremities the handles 48 end will be provic ed with the usual finger rings 51 and 52.

The is of the pivoting screw i6 of needle-receiving forceps B is at riojht angles of the pivot screw oi torceps'A when the two to each other for operthe attachment and rts such the t t and 4-9 of too torceps ere sec rely side the. of the needleJlelivering jar 49 above the jaw 4.7 seen in 1. ie 1 and ti e preferred orin of so vely lut det chabl securing the exinities of the aws oi. the needl -receiving ceps to the jaw 23 of the needle-delivering: i arceps is to have the extremities Q9 and 4? of the said jaws 49 and 4 enlarged or A; then by moving the jaws apart the extremities 4:7 and 4:9 are wedged into the undercut aperture 31 thus holding the jaws of tie receiving forceps securely attached .to the delivering forceps as long as the jaws 4-7 a ,d 49 remain apart which incidentally is the needle-receiving position for said forceps B. The jaws of the forceps B are thus held apart by means of o finger i323 on the outer end of the handle l8 being sprung into a. recess in the outer end of an oppositely di. posed fin 'er 54; on tie handle 50. Upon the finger may also be prorid-ed a peir o spring clips adapted to gly the reerwardly projectend 56 of the handle 24 and thus hold ndle end of the forceps l3 the right posi ion relative to jaw 23 and its handle 2% even though the other jaw 25 and handle 26 of the needle-delivering forceps are being moved. 7

The operation oi the complete device will be as follows assuming the two forceps to be already separated from each other: The prsh rod lO will be withdrawn to the necessary extent thereby withdrawing the plunger 36 to the rear end of the cavity 35; then a needle 32 with thread or suture 33 in its o at the res-or end will be passed point first throu h recess and aperture 43 and then hacl rear end first through aperture 4-3 into the needle-receiving cavity 35 thus leaving the free end of the thread extendout from the recess Then the needlereceiring forceps will be attached to the left hand jaw of the forceps A as already mentioned with the jaws i7 and 49 of the needle-receiving forceps open as far as allowed by the recess 81 thus securing the forward end the forceps A to the jaw 23. At the same time the handle end 0? these for eps will be attached to the rearward projecting end of handle 24: by means of swing clips 55. The instrument is new y to be placed in contact with the tissue to be sewed. The ja 23 and 25 of th die-deliver and flesh-grasping force a are u'zo'ved apart suthcseutlv to grasp the sue to be sewed and are then brought together upon the tissue to be sewed and C held in such grasping" position by the on gagement of its huge 29 and 30 Forward movement of the push rod etO pushes forward which in turn pushes o'oint oremost from the cavity 4e grasped between the and 49 from the recess 31 of jaw 23 and tied.

through apert ire 31 of jaw 23 and'both ends jaws 25 and 23 well into the curved pocket provided between the open jaws 47 and 49 of the need.e-receivin force s B. Thehandles of'the needle-receivingforceps are then sprung apart a. little to disengage the fingers. 53 and 54* and then the aws of the needle-receiving forceps are brought together firmly upon the middle of the needle By this motion the extremities 47? and 49 of the jaws 47 and 49 are released fromthe jaw 23 and may be withdrawn therefrom bringing the needle the rest through thetissue.

Preferably, however, before Withdrawing the jaws of the needle-receiving forceps from the 23 of the other forceps the j awe of the needle-receiving forceps will be locked in closed position securely upon the of the way needle therehetween by hooking the pointed catch 5"? on. finger 53 of handle 48 into one of the notches 53on the opposing finger 54.

Then the forceps B may be safely disengaged from the forceps A without danger of losmg the needle. The forceps B are disengaged by \Vltl'lClIflWlllg-tll} extremities 47 moving the jaws of forceps B to the' left enough to clear the needle from the tissue- The forceps B are then moved rearwardly so as to slip the spring clips 55 off from the rearward point 56 of handle 24hr without such rearward movement of the forceps B' thespring clips 55 may be sprung apart enough to disengage them fromthe point 56. As the forceps B are drawn away the thread or suturing material is drawn through the tissue resulting in the needle end of the thread projecting from the aperture 31 in jaw 23 on the left side of the tissue while the other end of the thread extends through the-aperture 43 in jaw 25 and outthrough the recess 42. The forceps B are now opened releasing the needle'and are laid aside. The needle-delivering forceps are then opened.

and may be withdrawn entirely leaVi-ng'opposite ends of the suture upon the opposite sides of the tissue. Preferably. however, the

forceps A may be further conveniently used to complete the tyin of the knot or knots f in the suture. of the thread which has the needle on it is slipped out from aperture in the jaw 23 and, a single knot ora surgeons knot is The needle end is then run back of the thread are held in one hand and the knotis pushed back into place and drawn. tight by opening" the jaws 23 and 25 of the forceps. Two or more knots may be'tied in a similar manner after which the long ends of the thread or catgut may be cut off leaving: the completed thread or suture in place. Tt will he noted particularlythat when the device is loaded with the threaded needle and ready for operation the needle For this operation the end is; entirely enclosed within'the casing 34 and that theneedle' stays thus guarded-untilit is pushed forward from the cavity 35 of".

saidcasing 34 intothe curved pocketbe tween the j awsof the receiving forceps B. When withdrawn from the body the point and the greater length of the needle is thus entirely enclosed between the jaws of the forceps B. It will thus be seen that there 1S7I1O danger of the needle in uring; any surrounding tissue or becominglost or dis-- engaged from the instrument.

It will be-further noted thatthe receivin forceps are positively secured to the jaw 23 that the needle cannot be reached. or drawn the rest of the way through the tissue. .Recess 42'makes a place for the thread as iti's crowded out .of cavity 35.

'lVhat I claim as new and desire to secure by Letters Patent is 1. In a' suturing lnstrument the combination of a: pair of flesh-grasping and needledelivering forceps and a pair of needle-receiving forceps, the'first jaw of the needledelivering forceps being extended away. from itsflesh-engaging face to provide a needle-holding cavity opening to the flesheno'agingface, the second jaw of the needle delivering; forceps having means for detach ably fastening thereto the jaws of the needlereceiving forceps and means for forcing tie I said. needle forward fromsaid holding cavity and'into' the space between thelreceivinp; jaws of-the needle-receivlng forceps.

2. In a suturing instrument, the combination of a pair of flesh-grasping and needledelivering forceps and a pair of needle-receiving forceps, the first jaw of the needledelivering forceps being extended away from its flesh-engaging face to provide a needle-holding cavity opening to the flesh:

engaging); ffl-(f6,'tl16 second jaw of the needledelivering forceps having means for detach ably "astening thereto'the jaws of the needlerecelvingforceps in open position and means for forcing; the said needle, forward from said holding cavity and into the spacebetween the receiving" jaws of the needle-receiving forceps.

3. In a suturingfinstruinent, the combination of a pair of flesh-grasping and needledeliveringforceps and a pair of needle-receiving; forceps, the first jaw of the needledelivering forceps being extended away from its flesh-engaging face to provide a needle-holding cavity opening to the fieshengaging face, the second jaw of the needledelivering forceps having means for detachably fastening thereto the of the needlereceiving forceps said needle-receiving forceps being released from the second fleshgrasping jaw when the jaws of the needle-- receiving forceps are moved to closed position and means for forcing the said needle forward from said holding cavity and into the space between the jaws of the needlereceiving forceps.

4. In a suturing instrument, the combination of a pair of flesh-grasping and needle delivering forceps and a pair of needlereceiving forceps, the first aw of the needledelivering forceps being extended away from its flesh-engaging face to provide a needle-hoiding cavity opening to the fleshenga-ging face, the second jaw of the needledelivering forceps having means for detachably fastening thereto the jaws of the needle receiving forceps in open position said needle-receiving forceps being released from the second flesh-grasping jaw when the jaws of the needle-receiving forceps are moved to closed position and means for forcing the said needle forward from said holding cavity and into the space between the jaws of the needle-receiving forceps.

5. In a suturing instrument, the combination of a pair of flesh-grasping and needledelivering forceps, a casing adjacent to the flesh engaging face of one jaw of the needledelivering forceps having a needle-holding cavity extending to the flesh-engaging face of said jaw, a plunger mounted to move to and fro in said cavity and force the needle forward from said cavity through the fleshengaging jaws and operating means connected to said plunger.

6. In a suturing instrument, the combi nation of a pair of flesh-grasping and needledelivering forceps, a casing adjacent to the flesh-engaging face of one jaw of the needledelivering forceps having a needle-holding cavity extending to the flesh-engaging face of said jaw, a plunger mounted to move to and fro in said cavity and force the needle forward from said cavity through the flesh engaging jaws, operating means connected to said plunger and means for holding the jaws of the flesh-grasping forceps in closed position,

7. in a suturing instrument, the combi nation of a pair of flesh-grasping and needledelivering forceps, a pair of needle-receiving forceps, a casing adjacent to the fleshengaging face of one jaw of the needle-delivering forceps having a needle-holding cavity extending to the flesh-engaging face of said jaw, a plunger mounted to move to and fro in said cavity and force the needle forward from said cavity through the fleshengaging jaws into the jaws of fit the needle-receiving forceps and operating means connected to said plunger.

8. In a suturing instrument, the combina tion of a pair of flesh-grasping and needledelivering forceps, a pair of needle-receiving forceps, a casing adjacent to the fleshengaging face of one jaw of the needledelivering forceps having a needle-holding cavity extending to the flesh-engaging face of said jaw, a plunger mounted to move to and fro in said cavity and force the needle forward from said cavitythrough the fleshengaging jaws and into the jaws of the needle-receiving forceps, operating means connected to said plunger and means for holding the jaws of the flesh-grasping forceps in closed position.

- 9. In. a suturing instruine tion of a pair of flesh-grasp delivering forceps, a pair of 1 ing forceps, a ca ing adjacent engaging face of one jaw of the livering forceps h g necavity extending to the flesh-e of said jaw, a plunger mounted to and fro in said cavity and force th forward from said cavity thror engaging jaws and into the a dle-receiving forceps, operatin nected to said plunger and means fo tachably holding the jaws of the g forceps in open position adjacent to the second aw of the flesh-grasping trceps.

10. in a suturing instrument, the combination of a pair of fleshy and needle-delivering forceps, a pa of needle-re ceiving forceps, a casing ad acent to the flesh-engaging face of one jaw of the needledelivering forceps having a needle-holding cavity extending to the flesh-engaging face of said jaw, a plunger mounted to move to and fro in said cavity and force the needle forward from said cavity through the eeh engaging aws and into the jaws of the needle-receiving forceps, operating means connected to said plunger and means for positively holding the jaws of the receiving forceps in open position adjacent to the second jaw of the flesh-grasping forceps, said means allowing the receivin aws to be dctached when moved from open pos tion.

11, In a suturing instrument, the c 'nbi nation of a pair of flesh-grasping: and 1';

and fro in said cavity and force the needle forward from said cavity through the fleshengaging jaws and into the jaws of the needle-receiving forceps, operating means connected to said plunger, means for holding the jaws of the flesh-grasping forceps in 9 closed position and means for detachably dle-delivering forceps, a pair of necdleare ceiving forceps, a casing adjacent to the flesh-engaging-face of one jaw of the needle-delivering forceps having a needle-hold ing cavity extending to the flesh-engaging face of saidjaw, a plunger mounted to move to and fro in said cavity and force the needle forward from said cavity tl'irough the flesh-engaging jaws and into the jaws of the needle-receiving forceps, operating means connected to said plunger, means for holding the jaws of the flesh-grasping forceps in closed position and means for positively holding the jaws of the receiving forceps in open position adjacent to the second jaw of theflesh-grasping forceps, said means allowing the receiving; jaws to be detached when moved from open position.

13. In, a suturing instrument the combr nation of a pair of flesh-grasping and needle-delivering forceps having apertures in each jaw for the passage of the needle'therethrough, a needle-enclosing casing extending back from one jaw of the forceps and having a recess back of the jaw "tor the pas sage of the thread and means for pushing receive the needle, a needle-enclosing casing extending back from one aw of the needledelivering forceps and having a recess backof the-jaw for the passage of the thread and means for pushing the needle forward from the casing: through the flesh-engaging; jaws and into the pocket between the jaws of the needle-receiving forceps. i

15. In suturinginstrument the combination of a pair of flesh-grasping and needle-deliveringforceps having, apertures in each aw for the passage of the needlethere-i through a pair of needle-receiving forceps having a curved pocket between the jaws thereof to receive the needle, a needle-enclosing casing extending back from one jaw of the forceps in a curve and means for push ing the'needle forward from the casing through. the flesh-engaging jaws and into the curved pocket between the jaws of the needle-receiving forceps.

In witness whereof I have afiixed my signature, this 15th day of November 1921. EDWIN P. BUGBEE.